Lizards and Diabetic Medication

As improbable a connection as lizards and diabetes might seem, there is a tie. The injectable drug Byetta (exenatide) is a synthetic version of a chemical found in the saliva of the gila monster, a reptile native to the Southwestern U.S. and Northwestern Mexico. Doctors may prescribe Byetta to patients with type-2 diabetes who have had little success controlling their blood sugar levels with oral medications.

History

• Research linked lizard venom and insulin production.

  In the 1980s, a researcher at the Bronx VA Medical Center in New York discovered a link between gila monster venom and the body's ability to produce insulin. Endocrinologist Dr. John Eng found a protein in the venom that stimulated the role of the intestines in decreasing blood sugar. Eng dubbed the protein extendin-4, and applied for a patent. In the 1990s, he licensed his findings to a San Diego company, Amylin Pharmaceuticals. Amylin partnered with Eli Lilly to manufacture exenatide, giving it the commercial name Byetta.

Background

• The injectable medication mimics the function hormones.

  The U.S. Food and Drug Administration approved the use of Byetta in 2005 for people with type-2 diabetes. Byetta is an injectable prescription medication designed to improve blood sugar control, and was the first in a new class of type-2 diabetes drugs called incretin mimetics. This class of drug "mimics" hormones that are produced naturally in the intestines.

  Byetta is not insulin; in fact, the FDA approved it as an adjunct therapy for patients who were not having success controlling blood sugar on two widely prescribed oral diabetes medications.

Benefits

• Patients may eat less.

  While Byetta is not designed specifically for weight control, some patients have lost weight on the medication. Researchers indicate Byetta may slow the passage of the food through the system, so patients feel full longer after meals.

Considerations

• Patient may feel nauseous after injection.

  The most common side effect from Byetta is mild or moderate nausea after injecting the drug. The nausea may lessen over time. Patients taking Byetta in combination with the oral medication sulfonylurea have an increased risk of hypoglycemia, or low blood sugar. Endocrinologists also advise people with serious kidney problems to avoid using Byetta because it may interfere with kidney function.

Warning

• In 2007 and 2008, the FDA issued patient safety warnings on Byetta after receiving reports of patients with cases of acute pancreatitis, an inflammation of the pancreas. The FDA noted six life-threatening cases of pancreatitis; two of those patients died. Experts cautioned patients to discontinue Byetta if doctors suspected an inflamed pancreas. The FDA also warned health care professional not to restart them on the drug.